The US Government Botched Its Investigation Into The Mysterious “Sonic Attack” In Cuba, Emails Reveal

“The fundamental problem is you can’t trust anybody here,” said one medical ethicist. “Not the US State Department and not the Cuban government.”

The second time the American diplomat felt the attack was in her apartment kitchen, after a long day working at the US Embassy in Havana. “I felt an extreme pressure like the full, frontal top of my face was exploding off my head.”

Unsteady on her feet afterward, unable to work, she was medevaced to Miami and diagnosed with a traumatic brain injury. But what caused that injury, and more like it to dozens of other US diplomats and their families? That’s still unknown — and may stay that way due to the way the US State Department began the medical investigation into what happened.

“Day to day, we still don’t know how to attribute it,” said the injured diplomat, who spoke to BuzzFeed News anonymously to preserve her future chances of working overseas.

For the past three years, diplomats working in Cuba have complained of an array of mysterious ailments and symptoms — dizziness, headaches, difficulty concentrating — that often started with reports of metallic shrieks inside their homes in Havana. Many report long-lasting, perhaps permanent effects.

The “Havana syndrome” mystery has been the subject of intense, and public, scrutiny, with much of it focused on the search for some sort of weapon — ultrasound, microwaves, psychology, and even crickets have been offered as explanations. Yet despite intense political pressure, international headlines, sanctions against Cuba, and withdrawal of most US diplomats from Havana, very little still is known about the cause of the “health attacks” as then–secretary of state Rex Tillerson described them in 2017, that affected at least 40 US and Canadian personnel working in the country.

The syndrome is now under investigation by the big guns in biomedicine, federal health agencies, and the US National Academies of Science. But public health experts who spoke to BuzzFeed News said the State Department dropped the ball by not opening the investigation earlier to a wider swath of medical experts outside of its immediate sphere.

“The fundamental problem is you can’t trust anybody here.”

According to interviews with public health officials and affected personnel, as well as documents obtained by BuzzFeed News via a Freedom of Information Act request that included hundreds of emails exchanged between researchers and the US Navy’s research office, much of the early research into the mystery may have been botched or biased. The initial investigation was confined to two competing sets of researchers, both eager to publish studies on their own work, and whose findings have been at odds with each other. In one case, researchers were also seeking to promote their own newly approved medical device as a diagnostic tool. And until now, the effort has lacked broader oversight by an institution capable of cross-disciplinary research.

“The fundamental problem is you can’t trust anybody here,” said medical ethicist Sergio Litewka of the University of Miami, who has written about the political cloud of secrecy and distrust surrounding the diplomats’ injuries. “Not the US State Department and not the Cuban government.” (BuzzFeed has filed a lawsuit with the State Department requesting its communications related to the medical research into the injuries, after the agency denied a request for them on medical privacy and ongoing investigation grounds.)

The two medical teams the State Department first tasked with treating victims — one from the University of Miami Miller School of Medicine and the other from the University of Pennsylvania’s Perelman School of Medicine — diagnosed the diplomats with injuries centered on their own respective areas of research expertise: inner ear damage and concussions. That drew criticism from other medical experts who saw them and the State Department as embracing familiar theories while closing off other explanations, ranging from viruses to poison to mass psychology.

“Medical groups do tend to see what they are used to seeing,” University of Virginia applied ethics professor Deborah Johnson told BuzzFeed News, comparing the situation to the joke about intoxicated people who look for lost keys under a streetlamp because that’s where the light is. “It’s why it is best to hear from a lot of disciplines in an investigation.”

Until now only those two US medical teams have reported, inconclusively, on the injuries to 26 US diplomats (and 14 Canadian ones) that began in Havana in late 2016. The US National Academy of Sciences will begin an investigation starting in the next few weeks, consisting of three standing committees of varied specialists investigating for a year. But outside experts are worried it might be too late to crack the case, starting now one year after the last report of injuries in Havana. They also fear that the State Department and other federal agencies have hobbled the medical investigation by keeping the details closed and hidden from the outside world.

“The National Academy is an excellent choice, likely to bring in sophisticated scientists with a good arm’s length from the political players,” UCLA neuroscientist Mark Cohen told BuzzFeed News. “I hope that the NAS will also take the step of bringing in experts from outside the US, as well.”

Emails show the teams quarreled, refused to share data, and disagreed over study authorship, as they raced to publish in high-prestige publications.

The State Department does not fund medical research but, after the teams from Miami and UPenn failed to reach a consensus, did ask the CDC to investigate the injuries in December 2017. The CDC has not yet published the results of its investigation, more than a year later. The NIH’s brain trauma research, now open to injured diplomats and their families, is a five-year study.

“Our response continues to be guided by the medical facts,” State Department senior medical adviser Behzad Shahbazian told BuzzFeed News in a statement. “World-class brain injury specialists and other scientists” at UPenn, NIH, and CDC, he said, “continue to examine the medical data to gain a better understanding of the nature and mechanism of injury that caused these patients’ symptoms.”

But according to public records obtained by BuzzFeed News, emails show the teams quarreled, refused to share data, and disagreed over study authorship, as they raced to publish in high-prestige publications. (The UPenn team requested copies of their own emails, and then declined to comment on them to BuzzFeed News. The Miami-led team responded after it was presented with a list of incidents in the emails.)

The emails show the Miami-led team discussed turning the investigation into a multiyear effort at the US Office of Naval Research (ONR) and, more unusual, also looked at the research on the injured diplomats as a marketing opportunity for diagnostic goggles — a medical device that one researcher and his university had a patent application on. (Via a spokesperson, the researcher denied having a financial interest in the patent.) They also worried about “State trying to reclaim ownership” of the investigation, according to their communications, which also privately suggest some saw little chance that the cause of the illnesses that started more than two years ago in Havana would ever be found.

In November 2016, the first cases of strange noises and injuries began appearing among a handful of diplomats posted to Havana. Initial reports were of buzzing sounds inside private homes. Embassy security at first thought these were just noises meant to annoy staff, according to US Senate testimony by State Department security official Todd Brown. The erratic nature of the incidents, a few one week, and then none another, added to the confusion, but by February 2017 it was clear that around half a dozen embassy staff were ill with headaches, hearing loss, or vertigo.

From the beginning, the medical investigation into these reports was ad hoc, a side project run by the doctors tasked with diagnosing and treating the diplomats and their families. The research investigation was allowed by the State Department, but not run by it.

“I literally got this call, ‘This is the State Department, we have a problem,’” University of Miami medical school otolaryngologist Michael Hoffer told a Pentagon-sponsored presentation last August. “All of these individuals had experienced a loud noise or pressure before and during the symptoms.”

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Hoffer, a former Navy doctor with two decades of military experience, had experience with blast victims who sustained traumatic brain injuries during the Iraq War, even receiving funding from the NFL Foundation for his research. Since Miami was the evacuation point for the embassy, it made sense for the State Department to ask the University of Miami expert to look at what resembled head injuries. He and his colleagues examined evacuated staff members with injuries in Miami, giving them neurologic, hearing, and physical exams. He later traveled to Havana to see many more, mostly unaffected personnel.

In late March 2017, embassy staff were gathered in Havana by then-ambassador Jeffrey DeLaurentis, who warned them about the incidents and said they would be evaluated if they wished. It was the first time many had heard about the injuries or the sounds. According to news reports, Canadian diplomats and their families, including children, also began reporting such ailments that month — including headaches, nosebleeds, dizziness, and ringing in the ears — from similar sound-linked incidents. (Fifteen Canadians, including five diplomats, sued their country in February, charging that their government “downplayed the seriousness of the situation, hoarded and concealed critical health and safety information, and gave false, misleading, and incomplete information to diplomatic staff.")

And the injuries kept coming.

“Like a teapot on steroids, such a very high-pitched sound,” the injured American diplomat told BuzzFeed News about the incident in her Havana apartment in April 2017, one month after the embassy town hall. While in her apartment kitchen, “I literally had to duck around a corner to get away from it,” she said.

“Like a teapot on steroids, such a very high-pitched sound.”

Her vision started to blur over the next three days, so she went to a Cuban eye doctor, who diagnosed bleeding in her retinas. “We couldn’t tell the [Cuban doctor] anything,” she said, but the State Department quickly evacuated her as soon as she alerted them about the problem. She stayed in Florida for about six weeks for treatment for her eyes, before returning to Havana “to resume life.”

Shortly after her return, there was a second incident in the apartment, accompanied by a buzzing noise. She said, “A sudden force on my face was pulling it up, everywhere above the nose.” Afterward she felt unsteady while walking and had fatigue and difficulty concentrating. She was evacuated to Miami, where she was evaluated for a traumatic blast injury, in the process donning a pair of experimental diagnostic goggles that tracked her eyes to measure the severity of her vertigo, and serving as a data point in Hoffer’s research. (Essentially, the goggles claim to track how the pupils of the eyes constrict in response to seeing objects move back and forth, an involuntary response that people with even mild traumatic brain injuries find difficult.)

By April, the University of Miami’s Hoffer had invited his longtime colleagues, bioengineer Carey Balaban of the University of Pittsburgh and Kurt Yankaskas, their grant officer at the US Navy’s Office of Naval Research hearing loss program, to collaborate on investigating the diplomats’ injuries. The three scientists discussed inner ear “cavitation,” damaging implosions of blood bubbles caused by focused sound waves, as an explanation. In an email obtained by BuzzFeed News, Balaban shared a proposal for a “blood vessel” grant with Yankaskas later that same month.

Still more diplomats reported injuries. On May 23, 2017, the State Department told Cuba to send two of its diplomats home from its Washington, DC, embassy, unsatisfied with the Castro government’s protests of innocence concerning the injuries. Cuba had a long history of constant surveillance aimed at US diplomats. It was also known to engage in petty harassment, such as leaving unplugged refrigerators and cigarettes in ashtrays after break-ins. It made the notion of the regime lacking any knowledge of the injuries, or responsibility for them, implausible in US eyes.

In all, Hoffer’s team would see 25 diplomats or their families affected by the incidents, 10 who lived with them but were unaffected in Miami, and another 105 unaffected personnel seen separately in Havana. “There was no media attention given to what was happening in Cuba when we saw these individuals,” Hoffer said at the later Pentagon teleconference, calling the group “in a sense, pure.”

On July 6, 2017, Hoffer and other medical experts met with federal officials, reportedly including top State Department medical officer Charles Rosenfarb, to discuss the still-secret injuries with the diplomats. The expert panel “came to a consensus that the initial findings were most likely related to neurotrauma from a non-natural source,” according to the Journal of the American Medical Association (JAMA).

That consensus was perhaps unsurprising, given the experts who were looking under the lamppost: They included neurologists and hearing specialists from the National Institute on Deafness and Other Communication Disorders, and the Johns Hopkins University School of Medicine, according to a State Department email asking them for travel receipts. But there were no infectious disease, toxicology, tropical medicine, or psychiatric experts listed as meeting specialists — no one who might have had a competing explanation for the injuries was present. Competing theories would, however, come into play much later.

Complicating any collaboration, and the research overall, was secrecy about the injuries. This remains a problem today. BuzzFeed News asked the four scientists from Johns Hopkins who were listed as participants in the July 2017 meeting, for example, to comment on the progress of the medical investigation into the Havana injuries so far. A university media representative said that one, otolaryngologist Frank Lin of the Cochlear Center for Hearing and Public Health, had signed a nondisclosure agreement, and that the rest “can’t comment” for undisclosed reasons.

The July 2017 meeting also included neurosurgeon Douglas Smith of the University of Pennsylvania Perelman School of Medicine. The State Department looked to his Penn Center for Brain Injury and Repair, a highly regarded center for the treatment of brain injuries near Washington, DC, where many of the injured diplomats and their families lived, for their extended treatment.

“It was good care, they took very good care of us,” the injured diplomat said of UPenn. “They told me, ‘We need to fix you and make you better,’; they would treat us like anyone else who came into their center with our symptoms.”

Outside, however, a storm was brewing. On Aug. 9, 2017, in answer to a question from a CBS News correspondent, State Department spokesperson Heather Nauert said that some embassy personnel “reported some incidents which have caused a variety of physical symptoms,” and mentioned the expulsion of Cuban diplomats in May. Headlines quickly erupted of “hearing loss” and “brain damage” to diplomats caused by an “acoustic attack,” all suggestions that outside experts have later found questionable.

Cuban state television in October 2017 blamed the noises heard by the diplomats in the incidents on cicadas or crickets, something the diplomat interviewed by BuzzFeed News scoffed at. “I’ve heard cicadas before,” she said. “It sounded different.”

In September, another injured diplomat who spoke to BuzzFeed News under similar conditions of anonymity was evacuated from Havana ahead of Hurricane Irma, which devastated the island. He had heard a buzzing noise in his home and the sensation of pressure, followed by problems with vertigo. “I fell out of my chair at work,” he said. He was also evaluated at UPenn, and is back at work now in the US, although he still has trouble concentrating.

“I don’t function at the level I did before,” he said, and worries about the long-term effects, especially, he said, in light of the US government’s longtime wrangling with war veterans with unexplained illness tied to Agent Orange and Gulf War syndrome.

By the middle of August, according to emails reviewed by BuzzFeed News, Hoffer’s University of Pittsburgh colleague Balaban was corresponding with Smith about collaborating on a study of how UPenn’s brain images of injured diplomats might explain how ultrasound beams could selectively damage a person’s inner ear from a distance.

“Your data will be very important in narrowing down plausible scenarios,” Balaban wrote in an Aug. 20, 2017, email to Smith. Smith was dubious, asking how ultrasound “can go through air and [a] possible glass pane, then the skull, to selectively affect the brain.”

Competition to publish research results first is the lifeblood of US scientific process. But for Havana syndrome, this drive pitted the two medical teams against each other in a race to publish in the world’s two most prestigious medical journals, the New England Journal of Medicine and the Journal of the American Medical Association (JAMA). The fastest team, from UPenn, would submit a paper to a journal within a few weeks of looking at the last diplomats in their study.

By November 2017, Hoffer and Balaban were drafting a paper on the diplomats that they had seen, which they planned to submit to the prestigious New England Journal of Medicine. That same month, the Food and Drug Administration approved sales by Pittsburgh-based Neuro Kinetics Inc. of the diagnostic goggles that Hoffer used to assess the diplomats’ injuries. Along with his university, Balaban had applied for a patent on the goggles with Neuro Kinetics. They shared the news with Yankaskas, their US Navy ONR grant officer:

“It does not seem imprudent to speculate that a highly specific unidentified energy exposure, perceived as a sound or pressure, could be producing a mild traumatic brain injury (mTBI) or similar inner ear concussion,” said a December 2017 update of the draft paper, obtained via FOIA request. It compiled symptoms that ranged from ringing ears to foggy thinking to dizziness, all signs of inner ear damage, to come to this conclusion.

Such symptoms were hallmarks of the blast damage to the head that the medical team had seen and diagnosed during the Iraq War. Those investigations, too, were not without controversy. The Defense Department’s inspector general in 2011 released a report critical of research that Hoffer and Balaban had conducted on US soldiers at Camp Al Taqaddum, Iraq, who were injured by explosions from 2008 to 2009. “Neurological assessments did not adhere to clinical practice guidelines” for mild traumatic brain injury, the report found. It also said that a “potential financial conflict of interest” in the experimental antioxidant tablets was not revealed to the injured personnel in the study, a research ethics violation. (Hoffer held patents on a method of administering the tablets.) A US Navy representative told Time, “The evidence suggests that no physical harm was caused by the administration of the investigational drug,” after the report came out.

To close out 2017, the State Department asked the NIH to investigate the diplomats’ injuries — a move the top Republican and Democrat on the House Foreign Affairs Committee called for on Dec. 5 — with staff members quoted as critical of the medical investigation.

In January 2018, the journal JAMA notified Balaban and Hoffer that the UPenn doctors had submitted their paper and added them as coauthors. The notice led to an angry face-off between Smith and Balaban, who wanted to see the data and delay publication of the JAMA paper. He told Smith he had complained to ethics officials at the University of Pittsburgh, which posed the threat of a scientific misconduct investigation. (University of Pittsburgh’s communications office did not respond when asked if there had been an outcome of that complaint.)

JAMA released the UPenn study online less than a week after Smith told Balaban he was either “in or out,” without him or Hoffer as authors. The study of 21 people, 11 women and 10 men, concluded “they had sustained injury to widespread brain networks,” a constellation of symptoms similar to concussions caused by physical impacts. “Clinically, it’s clear they have suffered some sort of neurological insult. Something happened,” UPenn’s Randel Swanson, the lead author on the study, then told BuzzFeed News.

Other experts weren’t so certain. Neuroimaging expert Arthur Toga of the Keck School of Medicine at the University of Southern California told BuzzFeed News the study was “inconclusive,” noting its MRI results didn’t indicate anything grossly wrong with the diplomats’ brains that corresponded to their symptoms. Neuroscientist Sergio Della Sala of the University of Edinburgh said that the study’s standard for brain damage, seen in only two or three patients, was so loose as to describe roughly 40% of the general population as having brain damage.

“Clinically, it’s clear they have suffered some sort of neurological insult. Something happened.”

The JAMA study authors noted that privacy and secrecy restrictions precluded the release of some of the data about the injured diplomats, noting that only Smith and Swanson were responsible for the data. Nonetheless, they ruled out a viral cause of the injuries, because no one had reported a fever, and called poisoning unlikely to have worked so quickly after the sounds heard by 18 of the 21 patients, some of them on the island for less than 24 hours before reporting symptoms. It also ruled out a mass psychology or “functional” disorders, triggered by everything from whiplash to migraines, because the diplomats wanted to return to work and didn’t show signs of “malingering.”

This last conclusion is at odds with how “psychogenic” injuries actually work — people suffer physically from injuries triggered by stress in such cases, often with symptoms like dizziness, headaches, and the others reported in some of the Havana cases. They do not fake injury to get time off work. Despite the presence of neuropsychologists on the UPenn team, the description called into question how well the JAMA study authors had really investigated the possibility of psychology to explain the injuries, medical sociologist Robert Bartholomew, coauthor of Outbreak! The Encyclopedia of Extraordinary Social Behavior, told BuzzFeed News.

Four days after the study appeared in JAMA, the State Department’s Rosenfarb gave Balaban and his colleagues authorization to publish their own paper in submission with the New England Journal of Medicine. “My apology for the delay,” said Rosenfarb.

They had lost the high-prestige publication race, and the delay hadn’t helped, according to an April 2018 email from Balaban. “An NEJM editor has asked us for rights of a first look before the JAMA paper was published. Our release occurred after the JAMA on-line edition appeared,” he wrote to a University of Pittsburgh publicist planning a news conference with the University of Miami’s medical school on publication of their paper, now under consideration by the journal Frontiers in Neurology.

Plans for the press conference included a presentation of the Neuro Kinetics goggles that the paper described as able to uniquely diagnose people with the Havana injuries, as well as setting up advance interviews with the Miami Herald and the New York Times. A draft of the paper in review with Frontiers lists no financial conflicts of interest in the study.

That seems troublesome to neurologist Mitchell Joseph Valdés-Sosa of the Cuban Neuroscience Center, a leader on a Cuban panel that concluded in 2017 that the injuries were likely caused by mass hysteria. “There could be a conflict of interest, and that could have [led] to confirmation bias,” he told BuzzFeed News by email. “Their hypothesis could have been that they were going to find evidence of vestibular [inner ear] damage, which is what the [Neuro Kinetics] helmet measures.”

In response to this concern, University of Pittsburgh media relations director Joe Miksch told BuzzFeed News by email, “Balaban has not and will not receive any financial benefit from Neuro Kinetics or the sales of the Neuro Kinetics diagnostic goggles, even if the patent is granted.” He did not answer whether Balaban’s employer, the university, which owns intellectual property on the patent and can license the invention, would financially benefit from the goggles. The university has not entered into any license with Neuro Kinetics, according to Miksch.

The last report of a US diplomat injured in Havana came one year ago, in May 2018. Cuba’s foreign ministry said the US State Department had informed it that a woman had “reported health symptoms as a result of ‘undefined sounds’ in her place of residence.” That same month, Secretary of State Mike Pompeo reported that two US diplomats in China reported the same sort of illness “entirely consistent” with the past Cuban cases, prompting the State Department to launch a task force with the Health and Human Services and Energy departments to investigate. (Eventually 15 US diplomats from China would be investigated for such incidents, with the Associated Press later reporting that 14 of them were ruled out from suffering the syndrome, with the 15th inconclusive.)

In August, a series of letters critical of the JAMA study were published in that journal, written by a mixture of neurologists critical of the brain damage claims, and experts in “functional” disorders triggered by stress who blasted its dismissal of psychology as an explanation.

“Research with this patient cohort was not originally anticipated due to secrecy and privacy concerns,” Smith and his colleagues said in response to the letters. They restated the criteria for “neuropsychological impairment” and wrote, “we are performing advanced neuroimaging studies of the patient cohort, hoping to identify structural brain changes that may underlie the neurological manifestations.”

These studies have still not been published. As mentioned, after asking to see the public records of communications released to BuzzFeed News, Smith did not reply to requests for comment.

“I can only vet the (published) cognitive data, and these do not hold water,” Della Sala, the editor of the journal Cortex, told BuzzFeed News by email. “These further explanations made things even worse.”

Also unpublished was the submitted Frontiers in Neurology paper by Hoffer’s team. The next appearance of their results instead came in August in talks at a “SOFWERX” Defense Department think tank in Tampa, where Hoffer discussed the injuries suffered by the diplomats. Balaban described the “Frey effect” in his talk, the production of clicking noises in the ears by exposure to microwaves, a phenomenon researched in the 1970s. “So, the ability of radiofrequency to affect the nervous system is real,” he said.

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Balaban also touted the Neuro Kinetics goggles at the talk, claiming a 90% ability to tell Havana subjects apart from either blast victims or healthy people. “This is a fieldable technology,” he said.

“The promotion of the silly goggles is a shameless attempt at commercial promotion,” said Cohen, the UCLA neuroscientist.

Little more than a week after Hoffer’s Tampa appearance, the New York Times published a story citing the Frey effect and suggesting that microwaves were the prime suspects as the technology that hurt the diplomats, with an endorsement of the idea from UPenn’s Smith. This caused some suspicion on both Hoffer’s and Balaban’s part that their August presentation had been eavesdropped upon and their ideas pilfered (in reality, a University of California, San Diego, news release had touted the idea a few days ahead of the story).

“I think State trying to reclaim ownership [is] a strong possibility because we noted that the Penn group (which is a group entirely composed of clinicians) now is convince[d] this is microwaves,” Hoffer wrote in a Sept. 2 note to Balaban and Georgetown University neuroethicist James Giordano, another colleague. “Definitely smacks of what we call ‘Penngazzi’. Lol.” The group discussed arguing for the Office of Naval Research, instead of the State Department, to lead an investigation into a “multi-layer” plethora of various kinds of energy beams causing the Havana injuries. They also discussed dropping a “red herring” as part of a “misinformation” campaign at their next talk, scheduled for later that week at a Pentagon-sponsored teleconference.

(As mentioned, BuzzFeed News has filed a lawsuit with the State Department for public records of Hoffer’s communications on his research.)

“There was no misinformation campaign,” Hoffer told BuzzFeed News by email. The “red herring” was a symptom to distinguish real Havana syndrome patients from pretenders, he said. “Indeed, we have seen patients who present themselves as such.”

“Definitely smacks of what we call ‘Penngazzi’. Lol.”

When asked about the context of the email suggesting the State Department was trying to reclaim ownership, University of Miami Miller School of Medicine media relations director Joanna Palmer replied, by email, “Dr. Hoffer has no further comment.”

Meanwhile, outside experts threw cold water on microwaves, calling the Frey effect wildly implausible as an explanation for the injuries, since its inner ear clicking noises it caused were far too weak to damage tissues.

“Maybe Fidel Castro is subjecting them to an ESP attack from beyond the grave,” said University of Pennsylvania bioengineer Kenneth Foster to BuzzFeed News, when shown the discussion of the “multi-layered” radiation attack idea. Foster, who has no affiliation with UPenn’s medical school team, first described the mechanism behind the clicking effect in 1974, but is dubious it is in play in Cuba. “Unless there is some independent evidence for an exposure of some kind, one could speculate endlessly.”

Nevertheless, the Pentagon teleconference received press coverage, noting Balaban’s theory of some confluence of radiation and ultrasound perhaps triggering targeted cavitation in the inner ears of the injured diplomats.

“I do not believe that we are close to claiming victory. In fact, I doubt that we can identify ‘the source’ for Cuba,” Balaban wrote to ONR’s Yankaskas in the aftermath of the news coverage.

In the outside world, skepticism abounded about both mystery noise-making secret weapons and the diagnoses of the research teams. On Oct. 8, 2018, a neuroscience reporter from another news outlet contacted Yankaskas at ONR, for example, asking whether they could discuss “wildly implausible” ideas that Balaban had presented, and questioned whether he had a “proprietary interest” in the diagnostic goggles.

Yankaskas forwarded the interview request to Balaban the same day, writing: “He’s the same reporter that I mentioned this morning.”

Asked by BuzzFeed News whether alerting a grantee about misconduct questions was appropriate, ONR communications director Robert Freeman told BuzzFeed News, “Grant officers typically have close relationships with grantees, and I might ask one, ‘Hey, what about this?’ if someone asked a question.”

He advised BuzzFeed News to submit the exchange to the US Navy’s Office of Inspector General, which might decide if it warranted an investigation. When it was pointed out that inspectors general don’t confirm or deny investigations to the public, he acknowledged, “That’s right, they generally don’t.”

Meanwhile, NIH was seeing some injured diplomats in Washington, DC, including the woman who spoke to BuzzFeed News. “It was definitely for research, not treatment,” she said. “We really miss the treatment at Penn. Now, we are all sort of on our own, seeing our own doctors now. There was some talk of the research continuing at Penn instead of NIH. We kind of wish it had.”

One person frustrated with both the UPenn and the NIH investigation was Mark Zaid, an attorney who represents some of the diplomats affected by the incidents in Havana. Another client of his, Michael Beck, a former National Security Agency counterintelligence officer, was the subject of a recent 60 Minutes report. Beck suspects he was exposed to a microwave attack while on an overseas assignment with a partner in 1996. Both of the men later developed Parkinson’s disease. In his effort to get Beck disability compensation, Zaid has gotten the NSA to release a 2014 letter, which reads, “The National Security Agency confirms that there is intelligence information from 2012 associating the hostile country to which Mr. Beck traveled in the late 1990's with a high-powered microwave system weapon that may have the ability to weaken, intimidate, or kill an enemy over time and without leaving evidence.”

Neither UPenn nor NIH will accept Beck into their study of the diplomats, said Zaid. “This guy might be the long-term result of whatever these people went through; wouldn’t you at least like to look at him?”

In December, the paper by Hoffer and Balaban was finally published in Laryngoscope Investigative Otolaryngology, a journal where Hoffer is an editor. It came to the same conclusion as the draft paper from a year earlier: “It does not seem imprudent to speculate that a highly specific unidentified energy exposure, perceived as a sound or pressure, could be producing an inner ear disturbance or demonstrate findings suggestive of a mild traumatic brain injury.” Among the findings in the paper was that only two diplomats actually had hearing loss, despite the initial headlines about deafness. Both of them had hearing problems before the incidents in Havana.

As with the JAMA study, outside experts such as Cohen complained the study took for granted that the diplomats had been attacked by some device and accordingly came to their conclusion. In science, this is called “confirmation bias,” as mentioned by Valdés-Sosa, seeking and finding information in a way that confirms one’s beliefs or hypotheses, while discarding alternatives.

Asked whether their communications pointed to good scientific practice in the medical investigation of the Havana syndrome, Hoffer told BuzzFeed News by email that they only reflect scientists “discussing possibilities” and “preparing papers for publications that sometimes don’t end up in the first journal to where they are submitted.”

“Yes that is the way good science is conducted,” he added.

Outside observers are less satisfied. “It’s just such a mess,” said Cohen, who along with other experts had long called for the National Academies of Science to weigh in on the Havana incidents. That panel’s start is still awaiting a contract, however, and Cuban scientists have not been contacted about participating.

For the research community, the next step will be seeing the epidemiological report the CDC produces, expected this year, followed by whatever NIH concludes from its five-year investigation.

“The evaluation of some of the diplomats at NIH is ongoing and any discussion about the evaluation would be premature. NIH has not drawn any conclusions at this stage,” NIH’s Renate Myles told BuzzFeed News by email. The State Department has offered entrance into NIH’s research to its injured employees, and healthy volunteers to serve as controls in the research.

“The safety and security of U.S. personnel, their families, and U.S. citizens is our top priority, wherever they are located,” State’s Shahbazian said. “We will continue to provide our colleagues the care they need, regardless of their diagnosis or the location of their medical evacuation.”

The injured diplomats still waiting on answers, however, are worried about the future.

“All of this research does not help us right now,” said the injured male diplomat who spoke to BuzzFeed News. “Some of us are not getting better.”

“What if this happens again, somewhere else overseas? What are we going to do when that happens?” ●

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